Prioriteren en delegeren in NCLEX-stijl: samenvattingspakket

On a postpartum unit, which patient is the most appropriate to assign to an LPN/LVN?

1. AOne hour after birth with heavy bleeding and a boggy uterus
2. BA new admission transferred from the labor ward with a fever of 38,6 °C
3. CSevere pre-eclampsia on a magnesium sulfate infusion
4. DDay 1 after an uncomplicated vaginal birth, stable vital signs

Four stable patients need routine morning care. To reduce the spread of infection, which patient should the nurse visit first?

1. AA patient with C. difficile diarrhea
2. BA patient with influenza on droplet precautions
3. CA patient with an MRSA wound infection
4. DA patient with neutropenia after chemotherapy

A nurse wants to set up a sterile field in the morning for a procedure that will take place after lunch. What is correct?

1. ASet it up in the morning and ask a colleague to check it once
2. BSet it up in the morning and leave it uncovered in an empty room
3. CSet it up just before the procedure, because a waiting field may become contaminated
4. DSet it up in the morning and cover it with a clean towel until the procedure starts

A nurse floated to an unfamiliar unit is asked to manage a device they have never been trained to use. What should the nurse do?

1. ADo it anyway, using only the device manual and the instructions on the screen
2. BTell the charge nurse and ask for help or a change of assignment
3. CAsk the patient or the family to explain how the device works
4. DLeave the device untouched and not tell anyone

A patient with pneumonia had a CRP of 180 mg/L on admission and 40 mg/L after 4 days of antibiotics. What does this most likely show?

1. AThe inflammation is settling with treatment
2. BThe infection has spread to another organ
3. CThe antibiotic is causing liver damage
4. DThe patient has developed a new infection

In the first 24 hours after a major burn, which laboratory pattern is most expected?

1. ALow potassium and low hematocrit
2. BLow sodium and low hematocrit
3. CHigh potassium and high hematocrit
4. DHigh calcium and high albumin

Why is it important to prevent hypothermia during and after surgery?

1. AIt increases the risk of wound infection, bleeding and cardiac complications
2. BIt makes the patient wake up too quickly and become agitated in recovery
3. CIt makes the patient's pain disappear
4. DIt causes high blood glucose only

During a general anaesthetic, a patient develops a rapidly rising temperature, muscle rigidity and rising carbon dioxide levels. What should be suspected?

1. AMalignant hyperthermia
2. BNeuroleptic malignant syndrome from antipsychotics
3. CPostoperative infection
4. DA normal response to surgery

A patient with stable angina is afraid nicotine patches will harm their heart. Which reply is most accurate?

1. APeople with angina must stop smoking without any help
2. BNicotine patches are much more harmful to the heart than cigarettes
3. CNicotine replacement is much safer than smoking and is recommended
4. DNicotine replacement only works if smoking continues

As the defibrillator charges, a nurse sees a colleague still holding the patient's bed rail. What should the nurse do?

1. AAsk the colleague to hold the patient's hand instead
2. BTurn off the defibrillator and start a new cycle of CPR
3. CDeliver the shock now, as the bed rail is not part of the patient
4. DCall clearly for everyone to stand clear and check before the shock

Welke bewering over de hyperosmolaire hyperglykemische toestand (HHS) is juist?

1. AHet treft vooral ouderen met diabetes type 2, over dagen
2. BHet veroorzaakt altijd hoge ketonen in het bloed en een ernstige metabole acidose
3. CHet ontwikkelt zich binnen minuten en is minder gevaarlijk dan DKA
4. DHet wordt vooral gezien bij jonge kinderen met diabetes type 1

A patient on haemodialysis is on a medical ward. Which task can the registered nurse delegate to a healthcare assistant (nursing assistant)?

1. ADeciding which morning medicines to hold
2. BWeighing the patient before they go to dialysis
3. CTeaching the patient about fluid restriction
4. DAssessing the thrill and bruit of the fistula

A dying patient can no longer drink. Which mouth care is most appropriate?

1. AFrequent, gentle moistening of the mouth and lips
2. BLemon and glycerine swabs every hour to stimulate saliva
3. CNo mouth care, to avoid disturbing the patient
4. DBrushing hard with a stiff toothbrush twice a day

Een patiënt met hepatische encefalopathie is 's nachts onrustig. Er wordt een benzodiazepine voor de slaap voorgesteld. Wat moet de verpleegkundige doen?

1. AHet geven, omdat de lever geen invloed heeft op sedativa
2. BHet in dubbele dosis geven om te zorgen dat de patiënt slaapt
3. CHet geven en de lactulose stoppen om diarree te voorkomen
4. DHet in twijfel trekken, omdat sedativa de encefalopathie kunnen verergeren